A new study finds many children and teens who receive treatment for a mental health condition don’t receive timely follow-up care, or receive care that appears to fall short of standard guidelines.

The study analyzed a large national database of insured children and teens ages 10 to 17 who had an initial insurance claim for a mental illness. Many either failed to receive follow-up care within three months, or received care that appeared to fall short of standard guidelines for the initial treatment of mental illness in children.

The majority did not receive therapy. Of those who did receive treatment, many were prescribed drugs that raise a red flag, such as benzodiazepines, tricyclic antidepressants, and drugs that are not Food and Drug Administration-approved for use in children, the researchers report in the Proceedings of the National Academy of Sciences.

The study’s authors noted that most professional guidelines would suggest starting with another type of antidepressant — an SSRI — in combination with therapy for the majority of children in the study, STAT News reports.